Vexing Vocabulary: Organic

In this edition of the Vexing Vocabulary blog series, we want to explore another commonly misunderstood nutrition buzz word: organic. We see it popping up in grocery stores more than ever before, but what exactly does “organic” mean?

 

It may be easiest to start with defining the non-organic food that we commonly consume. “Conventional” foods are what you could consider the opposite of organic. These may be grown using pesticides, synthetic or chemical fertilizers, herbicides, and insecticides to maximize the yield of the crop. The use of these technologies has been essential in the development of our agricultural system. It is important to know that the use of these conventional means of food production do not make foods unhealthy or unsafe for consumption. Rinsing and washing produce does not entirely eliminate pesticides, but can greatly reduce it. There is no conclusive research that pesticide, herbicide, or insecticide use are unsafe in the production of food.

 

In contrast to conventional food, organic food has limits on the technologies that can be used in production. Organic produce started being labeled as such in 1990, but there was no official definition of what classified the food as organic until the early 2000’s. Currently, of all of the food marketing terms, “organic” does have a legal definition and meaning. Before a farm or manufacturer can market their products as organic, a government certified inspector must confirm that the USDA standards are met in production. “Organic” means different things based on the food item. In the following paragraphs, we will define and provide examples of organic produce, meat, and dairy.

 

Produce:

Organic produce does not use pesticides in production. This means that any weeds are controlled by natural means, such as crop rotation, hand weeding, mulching, and tilling). Insecticides are also prohibited in organic food production, so natural methods of insect control are utilized (birds, traps, etc.). No fertilizers can be used in crop production that contain synthetic ingredients or sewage sludge, bioengineering, or ionizing radiation.

 

Meat and dairy:

No antibiotics or growth hormones were added to the food products that were fed to the animals, meaning that the livestock are also eating organic feed. In conventional meat and dairy production, livestock may be given antibiotics and other medications to keep them healthy, but this is not allowed in organic production. Organic livestock must also be raised in living conditions that promote their natural behaviors, such as grazing on pastures. This practice has been shown to contribute to the fatty acid content of meats, and is beneficial to the health of the animal.

 

Processed foods:

There are no artificial coloring, flavoring, preservatives, or sweeteners in organic food products. Organically processed foods must have organic ingredients, with several minor exceptions.  Examples of this would include enzymes in yogurts, pectin used as a binding agent in jams, and baking soda in baked goods.

 

Levels of Organic Labeling

How can you identify what foods are organic? The USDA enforces the labeling of organic foods. The Organic Foods Production Act requires the USDA to hold nationwide standards for organic agricultural products so the consumer is aware of what they are purchasing. There are four levels of organic labeling that you will see in grocery stores:

 

100% organic:

All ingredients of the finished product are certified 100% organic. These products can be labeled with the USDA Certified Organic Food label.

 

 

Organic:

95% of the ingredients of the finished product meet the organic criteria. These products can also be labeled with the USDA Certified Organic Food label shown above.

 

Made with organic ingredients:

70% of the ingredients of the finished product meet the organic criteria. The USDA Organic seal may not be used on the labeling of these products, but “Made with organic ingredients” may appear on the food label.

 

Specific organic ingredients:

This claim could be made on the food label of a multi-ingredient food product with less than 70% of its ingredients meeting the organic criteria. They may not display the USDA Organic seal, but they may list the organic ingredients that were used in the production.

 

The “Clean Fifteen” and “Dirty Dozen”

 

If you are interested in buying organic produce but have limited availability of organically grown fruits and vegetables, or are trying to keep an eye on cost, this can be a helpful tip!  The “Clean Fifteen” and “Dirty Dozen” can help you decide what produce is smart to buy organic versus conventional. The “Clean Fifteen” listed below on the left are found to have lower levels of pesticide residue than the “Dirty Dozen” listed to the right. If you are aiming to reduce pesticide residue in your diet, it may be helpful to purchase fruits and vegetables on the “Dirty Dozen” list that have been grown organically.

 

Clean Fifteen

1. Sweet potatoes
2. Cauliflower
3. Cantaloupe
4. Grapefruit
5. Eggplant
6. Kiwi
7. Papaya
8. Mangoes
9. Asparagus
10. Onions
11. Sweet peas
12. Cabbage
13. Pineapples
14. Sweet corn
15. Avocados

Dirty Dozen

1. Apples
2. Strawberries
3. Grapes
4. Celery
5. Peaches
6. Spinach
7. Sweet bell peppers
8. Nectarines
9. Cucumbers
10. Cherry tomatoes
11. Snap peas
12. Potatoes

 

A Final Thought

 

At this time there is no conclusive research that organic food items have any more health benefits than their conventionally produced counterparts. It’s important to know that the organic label does not inherently make a food “healthier.” With that being said, if you want to shop organic, we encourage and support you in doing so! There are environmental benefits associated with organic farming practice, including but not limited to:

 

• Reduced land mass allocated for corn* and soy production (a majority of corn grown in the U.S. is grown to feed livestock, and most livestock do not naturally consume corn).
• Improved fatty acid profile of meats (particularly with beef and eggs animals that consume their natural diet digest better, better utilize nutrients, more naturally partition nutrients, and as a result are healthier. Fat content in grass-fed beef is naturally lower and contains fats that are easier to breakdown. Free range organic eggs contain significantly more omega-3 fatty acids in the yolk of the egg.) For more information on this topic, look for our upcoming blog on grass fed, cage free, and wild caught!
• Improved quality of life for the animals being raised
• Improved allocation of resources to local consumers (reduced carbon footprint)

 

* Corn is a very demanding crop and is known for stripping nutrients from soil, depleting it over time, and reducing yield of other crops. There is evidence that the organic farming method which feeds livestock their natural diet of grass in pastures leads to leaner animals, increased availability of land mass for other farming practice, and an improved impact on the nutrient contents of the soil.

 

You may have noticed that organic food products are more expensive than their conventional counterparts. This is because the yield of organic food is typically lower, and more labor, time and money are invested into the production. If you are interested in buying organic foods, there are some ways to offset the higher prices. Shopping in season is an effective way to save money on organic produce. Fruits and vegetables that are in season are less expensive and fresher! It is also a good idea to shop around and compare prices of organic items. Taking advantage of local farmer’s markets is a great way to eat organic products and to support your community.

 

 

Resources:

 

http://www.eatright.org/resource/food/nutrition/nutrition-facts-and-food-labels/understanding-food-marketing-terms

 

 

https://www.usda.gov/media/blog/2012/03/22/organic-101-what-usda-organic-label-means

 

Supplementation: A Food First Approach

Supplementation has become increasingly popular in the United States over the past 20 years. Many products have potential application and benefits to target populations, but it is rare that a supplement truly enhances the health or performance of the general population better than an optimized diet. That said, there is always a place for supplementation, especially as a way to fill the gaps in the diet. Endurance athletes need to pay attention to a couple key nutrients during training. If these cannot be consumed adequately through diet, supplementation should be considered to prevent deficiency and keep the body functioning at its best.

• Calcium: Dairy Products, Kale, Collards, Black Eyed Peas, Fatty Fish, Bone Marrow
• Magnesium: Dark Leafy Greens, Nuts, Seeds, Fish, Beans, Lentils, Grains
• Iron: Meats, Animal Products, Seeds, Nuts, Beans, Whole grains
• B12: Meats and Animal Products
• B6: Meat, Starchy Vegetables
• Vitamin C: Citrus fruits, Peppers, Dark Greens, most Fruit

The vitamins and minerals listed above either have an increased need in endurance athletes, or tend to be under consumed by many runners. Using the sources listed, assess your intake of these nutrients on a daily basis. Ideally you are getting at least 3 servings of each of these items daily. If your consumption is below that amount, these items may be compromising your nutrition status and performance.

Vitamin C is the only micronutrient aside from the electrolytes that we know runners need more of. Estimates range between 200 and 500mg per day based on intensity and duration of activity. Supplementation is generally unnecessary for runners who use fruit as a carbohydrate source before, during and after activity. For those who choose to supplement, the body does not absorb much more than 100mg at a time, so the large doses of vitamin C are often wasted. Instead of buying 1000mg, try using 100mg doses spread throughout the day to maximize absorption.

All the other nutrients tend to be under consumed based on dietary restriction. Calcium is often hard to consume enough of without dairy, and magnesium is often lacking in those following energy-restricted diets. In both instances, attention to the food sources can ensure adequate intake with little effort. If dairy is not a food group in your diet, and you do not consume the other sources consistently, I usually recommend using almond or coconut milk twice daily. For those who prefer supplementation, calcium citrate is the best option for absorption. It can be taken in 600mg doses, or in smaller doses spread throughout the day.

Vegetarians commonly under consume iron, B12 and B6. Most of the time, supplementation becomes the most sustainable way to encourage adequate intake of these nutrients. Even omnivorous females often struggle to consume adequate iron daily. Women need significantly more iron than men. Unless the diet contains consistent red meat intake, or an individual uses a cast iron skillet, it is very likely a female runner will show signs of iron deficiency and even iron deficiency anemia without supplementation.

Overall supplementation is unnecessary in the general population assuming the diet is adequate. As a runner, it is important to look for gaps in your diet to assess your need for certain vitamins and minerals. Once you have identified areas of concern, try to integrate food sources into your day. If you find it hard to consistently consume enough of a certain nutrient, then supplementation may be a more sustainable option for you. Use diet to drive your success, and allow supplements to fill the gaps that exist!

 

Never Get Stuck

I don’t know about you, but I am a creature of habit. I like routine. Don’t get me wrong, spontaneity has its place in my life, but when it comes to most daily activities, I like to have at least a tentative plan. This can mean different things to different people. Some like to have the same schedule Monday-Friday. Personally, I like each day of my week to have variety, but I like the variety to be planned. What I do on Monday is likely not the same as on Tuesday, but my Mondays are all very similar. With this schedule, instead of having a daily routine, I have a weekly routine. Some people, especially those in health care, sales, city service and trade professions have a biweekly or completely unpredictable schedule.

There are pros and cons to all of the lifestyles above. A daily routine tends to become monotonous relatively quickly, but is great for planning and accountability. Alternatively, weekly, biweekly, or unpredictable routines do keep the mind better stimulated, but can also be difficult to manage at times. The more variety in your day equates to more decisions, and ultimately a need for better planning. Factors such as these need to be considered, especially when health and wellness is a priority in your life.

For those with weekly schedules, they have to learn to adapt to daily change. Most psychologists agree that it takes approximately 19-21 days to create a habit or routine. What happens if the routine is only performed once per week? The idea of mental adjustment is very crucial. The key is gradual adjustments in planned areas. Over time, the pieces of the plan come together to form a complete and optimized routine with daily variety.

Then we have the unpredictable schedules. Some of the more common jobs include nurses, doctors, small business owners, sales positions, and a variety of jobs that require frequent travel. For this group, it is often impossible to settle into a complete routine. There are likely some consistencies while at home, or in the office, but that may only account for a fraction of the week. The rest of the week often consists of travel to different states or countries, airports, hotels, restaurants, and a great variety in level of activity and time to plan. For someone trying to lose weight, build muscle, manage diabetes, or focus on healthy lifestyle choices, this poses a tremendous challenge. When challenges such as these present themselves, the key to maintaining a successful healthy lifestyle plan is to NEVER get stuck.

Since not everyone spends their time becoming a walking nutrition facts list, or automated calorie calculator, there are many tools and strategies that can be used to help control the unpredictable. Technology has become a huge asset for many. Apps like My Macros Plus, My Fit Pal, Calorie Counter, Food Tracker and many others can be reference lists for nutrition facts, and can help you track your day’s macronutrient distribution, and even estimate your caloric needs. Though these apps do not replace the knowledge and customization offered by a Registered Dietitian, it can be helpful, especially if used in combination with personalized consulting services.

Thanks to the dramatic increase in demand for transparency by consumers, eating healthy on the go is no longer the burden it was in years passed. All restaurants with more than 20 locations, particularly commercial fast-food chains, are required to have nutrition facts available. This is a huge asset for people who are stuck with limited options. Many fast-food chains offer grilled chicken salads with topping vegetables and a light, oil-based dressing. This makes it possible to eat fast food with attention to calories consumed, as well as macronutrient distribution and nutrient density. I always tell my clients, I don’t care where you are eating, there is always the opportunity to make an optimized decision. This option may not be necessary for everyone, but the take home message is there is no longer an excuse for unhealthy choices.

One of my most heavily utilized strategies is constant accessibility to smart snacks. Throughout my education and career, I have worked in environments with limited time to eat, limited access to the foods I want to eat, and in positions with very unpredictable days. Throughout all of these environments, my constant access to smart snacks is what helped me maintain my goals. Snacks will of course vary based on your individual goals, but many of the following items are ideal for use.

If you looked in my briefcase, gym bag and office drawers, you will find the following:

• A shaker bottle with my ‘Daily Whey’ protein powder ready to scoop and serve
• An apple pie or chocolate chip cookie dough Quest Bar
• A jar of Smucker’s Natural Creamy Peanut Butter
• A light string cheese (I prefer Jalapeno)
• Two rice cakes
• A ziploc bag of almonds, walnuts or peanuts
• A small organic apple
• Two small clementine’s
• A bag of baby carrots
• a 6oz container of plain greek yogurt
• Two hardboiled eggs
• A simple granola or fruit and nut bar
  • Kashi Bar
  • Lara Bar
  • Kind Bar
  • Bear Naked Granola Bar
  • Homemade Granola Bars

All of these items are quick, convenient, easy to eat, easy to store, and most importantly delicious! There are many other options that exist, but I find that these key items cover my bases. If I am on the go, I can select any one of these items to eat in less than 1 minute. I choose what I eat based on the type of activity I will perform. If I am stuck without food and will be sedentary, my need for carbohydrates is only for mental function. With those needs in mind, the combination of an apple and a light string cheese provides some much needed brain power, along with some protein and a couple vitamins and minerals worth mentioning. I will openly admit my briefcase always has a couple scoops of protein and a quest bar in it. This isn’t because I affiliate with the common misconception that I will wither away without a steady stream of protein; it’s because they are simply formulated and versatile products with a reasonable shelf life, and they store at room temperature. These items allow me to fulfill my protein requirements, and they leave me satisfied when I need a meal and can’t readily access anything. These items have saved me on numerous occasions, and are a fundamental reason for my ability to never get stuck.

The snacks above are designed for someone trying to prevent a bad decision. I find these helpful when I don’t have time to sit and eat a formal lunch. With the list above I can still get fruit, vegetables, nuts, and protein sources. But what about real food? Another component of never getting stuck is having access to real food.

To ensure access to proper meals, I am a supporter of the assembly line cooking method. It is an efficient way to prepare meals in advance, so you always have delicious and nutritious meals ready to go. Some of the key components include:

• Chicken, Beef, Pork and Fish can all be baked at the same temperature (350 degrees F), as well as grilled or sautéed. With this in mind prepare all your meats for the week in one hour.
  • Take cuts of each meat and season as you please. Place in oven in different pans.
    • Fish takes 25-30min, steak takes 30min, pork takes 35min, and chicken takes 40 minutes. In less than one hour you have a variety of meats prepared for the week, 90 seconds of microwaving away from the plate.
  • Rice, quinoa, couscous, pasta and potato all have similar carbohydrate profiles, which means equal servings can be swapped out evenly (½ cup-1 cup). Cook a blend of these with vegetables added and spice as you please when the meat is cooking so you always have some ready.
  • “Steamfresh” Vegetables: The frozen food section has gotten a make-over recently. Now, you are only 5 minutes away from 2.5 cup of fresh-steamed anything. The vegetables are an easy side to a pre-cooked meat, and provide plenty of micronutrients and fiber to keep your body running properly.

With these options you will always have access to nutritious meals, making pick-up and delivery less tempting and obsolete. Pair it with some smart snacks and you will stay satisfied all day regardless of your schedule.

 

Andrew Wade, RDN, LDN

Registered Dietitian, Smart Snacker

casespecificnutrition.com

If you want more articles about nutrition and lifestyle, visit pittsburgh-dietitian.com

Ketogenic Diet: Potential Applications

Thus far in the blog we have discussed endurance activity using carbohydrate as the primary fuel source. In the last three weeks we outlined the protocol for pre, during and post workout fueling. While our body does prioritize carbohydrate as the primary fuel source for activity and brain function, many endurance athletes agree that carb-centered fueling is both frustrating and time consuming. In recent years, the ketogenic diet has emerged as a popular choice among extreme endurance athletes for a couple key reasons. Today’s post will discuss an introduction to ketogenic dieting, what it means, the potential benefits, as well as potential concerns and obstacles. This post will not discuss the physiology of the process in detail. For those interested in a greater level of detail, I have posted links to some of my favorite resources on ketogenic dieting.

Simply stated, the ketogenic diet is built for those interested in running on fat. As mentioned repeatedly in this blog, our body will use carbohydrates for activity first when they are available. Since they are such a common part of our diet, many go through life never considering another way to eat. But what happens when our body has no carbohydrate stores left, and none are in the diet? Our body adapts to use a fuel that is always available, fat. When the body has no carbohydrate, and does not have enough protein to make carbohydrate from, the body will begin to adopt fatty acids as the primary energy source. Metabolism of fat in the body produces a group of compounds called ketones, which can be used by all systems in our body, including the brain. As I may have eluded to above, it takes quite a bit of time to enter ketosis, and is not done without resistance from the body. Once in ketosis, most people report a return in energy and mental clarity, and our body runs on ketones without any significant problems.

The application and interest in this diet with runners is fairly straightforward. The average person has enough carbohydrate stored to fuel activity for approximately 2hrs, or 15 miles (give or take 10 miles). To compare, the same person has enough fat to fuel activity for 500-700miles. We reserve and store fat very efficiently, and can readily use it when needed. As you reflect on the pre-, during- and post- training protocols from the last 3 weeks, it becomes obvious that our body does not have a great deal of carbohydrate stores. You are constantly taking in glucose from food during the entire training and event to keep stores available. Runners on the ketogenic diet don’t use carbohydrate, and therefore do not have to eat anything before or during their event unless they choose to (except water and electrolytes). For an avid athlete running long distances on a regular basis, this has a great deal of appeal. It becomes more enticing when they learn that not only are feedings surrounding exercise optional, there is no need to time meals or eat every 3 hours. Since your body is not using sugar, no insulin is being produced, and blood sugar levels are stabilized by a compound called glycerol, which is abundant as a result of breaking down triglycerides into fatty acids for oxidation. With no need to manage blood glucose, and muscle glycogen out of the conversation, keto-dieters can eat when they please with no impact on performance.

In addition to endurance athletes, this diet has potential application with individuals who have compromised glucose utilization. For pre-diabetics, non-insulin dependent diabetics, and others deemed insulin resistant, the ketogenic diet has the potential to serve as an alternative to carb management and medication. As noted above, the body does not use insulin, and blood glucose is maintained with glycerol. Instead of trying to manage the compromised system, many diabetics are choosing a different energy path, one that “skips using what is broken”. In the short-term this seems to have success in many individuals. Unfortunately, we have never witnessed individuals in our culture and time maintain ketosis for a life time. More research and time is needed to better understand what the long-term effects of this diet are. My personal interest lies within extreme endurance athletes and diabetics. Extreme endurance athletes are often training so intensely their body must rely on an enormous amount of sugar, which strains the pancreas. Any organ used in this fashion will wear down over time. Just from observation I have noticed many endurance athletes in their 60’s are pre-diabetic. Low body fat, great muscle mass, but struggling with this issue despite it all. What if instead of demanding such constant insulin production, they were able to use fat. While fat also demands function from the pancreas, the amount of fat needed for caloric balance is less than half that of carbohydrate. All of this is speculation, but I look forward to watching this area of science grow.

At this point it seems like this diet would have great application to the populations discussed. With all this potential, what is the catch? Why isn’t everyone doing this? Are there any concerns? While there is a tremendous amount of potential, there are certainly a number of issues that complicate the ketogenic diet as a viable option for many individuals.

The first obstacle for most is the transition into ketosis. Our body does not like to switch to fat as our primary fuel source. Traditionally this switch implied starvation. Our body stores energy very efficiently, and body fat is meant to be a reserve kept for dire circumstances. As our body reaches the end of its carbohydrate reserves, most experience extreme fatigue, dizziness, headaches, changes in bowel regularity and consistency, shakiness, muscle cramping, disruptions in sleep, a temporary dip in thyroid hormones, and even an increase in kidney stone formation. That long list of symptoms is intimidating to type let alone experience, so it comes as no surprise many cannot handle this during training, working and activities of daily life. It is important to note that these are temporary, often lasting from 1-3 weeks depending on rate of carbohydrate depletion.

Once in ketosis, the biggest issue becomes the sustainability of the diet. Maintaining nutritional ketosis for extended periods is a very different diet than we are used to, and does not resemble most other low carb diets. Carbohydrate intake is supposed to be nonexistent, so it is essentially restricted to the 2.5 cups of dark green, non-starchy vegetables per day, and 1-2 servings of nuts. The rest of the diet is protein and fat. The most difficult part of this plan is the protein limitation. As mentioned before excess protein will be turned into carbohydrate, so protein has a restriction in ketosis, which is the main way this diet differs from an Atkins or South Beach. This results in a plan that has a lot more fat than protein, which means foods that are exclusively fat must take a leading role. Things such as grass-fed butter, vegetable oils, coconut oil and MCT oil are often consumed at every meal. An example meal plan for a 5’9” 155lb male triathlete is below:

 

Example Day:                    2400 kcal              200g Fat               120g Protein                      30g CHO

Meal 1: (60g Fat, 30g Protein)

4 slices Bacon (14g Fat, 12g Protein) Pan fried in 1 Tbsp Coconut Oil (14g Fat)

3 eggs (18g Protein, 12g Fat) cooked in 1.5 Tbsp Grass-fed Butter (18g Fat)

8oz Unsweetened Almond Milk (2.5g Fat, 1g CHO, 1g Protein) *For Calcium

Meal 2: (49g Fat, 33g Protein, 10g CHO)

6oz 75/25 Grassfed Ground Beef (42g Fat, 26g Protein)

1oz Cheese (7g Protein, 7g Fat)

2 cups mixed Greens (lettuce, romaine, spinach etc) (10g CHO)

 

Meal 3: (35g Fat, 15g Protein, 15g CHO)

½ cup Almonds

 

Meal 4: (56g Fat, 38g Protein, 5g CHO)

6oz Salmon Filet (22g Fat, 35g Protein) cooked in 1 Tbsp Olive Oil (14g Fat)

1 cup Asparagus (5g CHO, 3g Protein) add 1.5 Tbsp Grass-fed Butter (18g Fat)

8oz Unsweetened Almond Milk (2.5g Fat, 1g CHO, 1g Protein) *For Calcium

 

*Use ¾ teaspoon of Himalayan Sea Salt with food daily (Sodium and trace minerals)

*Use ¾ teaspoon of Salt Substitute with food daily (Potassium)

*Drink 130 ounces of fluids daily before accounting for exercise

 

Notice how much pure fat there is in the diet? While some enjoy it, others find it unappealing and cannot stick with it. In addition to fat as a barrier, vitamins and minerals pose a problem. Many of our micronutrients come from fruits, vegetables, dairy and grains. While we can do our best to maximize some of them in the 2 servings of vegetables and serving of nuts, we are still left without adequate micronutrients. To achieve balance many keto-dieters will use bone broth. It is very hard to assure adequate intake with broth, so supplements are commonly used. As noted above, this individual used unsweetened almond milk as a calcium supplement, salt for sodium, and salt substitute for potassium. This individual also consumes a mineral and vitamin complex that is spread throughout the day to maximize absorption and provide key vitamins and minerals that are lacking.

While quite a few websites now boast recipes and options for keto-dieters, many people still struggle with the lack of variety, and miss certain foods. As a Dietitian, my job is to help people maximize their health. For me, health is a balance of quality and quantity of life. It varies for most individuals, and that is our right. The clients I have who maintain the ketogenic diet are those who do not have strong social and emotional ties to food. While in many ways this is a positive attribute, it is a rare one in our culture. The ability to look at food as simply “energy to perform and sustain life”, will usually result in successful ketosis, but may also restrict certain social ties to food that many would argue impact quality of life.

A large barrier in the world of performance is application to certain athletes. While many view the ability to fuel on fat through endurance races as an advantage, there is one lingering disadvantage. Our body’s anaerobic systems, the energy systems that function when there is not enough oxygen, are exclusively reliant on carbohydrate. In simpler terms this means that when you are exerting yourself at maximum intensity, you rely exclusively on carbohydrate for fuel. In ketogenic dieting, there is no carb, so there is no true max performance. Endurance athletes are rarely concerned with this, as their push to the finish is often not going to be at max performance, but many athletes rely on anaerobic systems to compete. Sprinters and those athletes who rely on short bursts of high intensity will not see a performance benefit from this diet. Most of the studies investigating performance in ketosis note an increase in perceived rate of exertion, and an inability to reach max effort (White 2007), meaning they felt like they were working harder compared to when they were eating carbs for the same intensity, and they were unable to achieve max intensity. This is why the diet is most popular in endurance sports and why Lebron James only went “low-carb” in his offseason.

Aside from the daily life and performance concerns that many will find discouraging, we also have a lack of vision for the long-term impact of the diet on health. There are quite a few personal testimonials of individuals feeling great at a healthy body weight with encouraging clinical indicators of health for 5 and even 10 years in ketosis. This is quite encouraging, but we need much longer and better controlled trials. While it is true that diets with too much carbohydrate, particularly refined and processed carbs, can cause a host of problems in very little time, we have abundant data proving a eucaloric diet containing carbohydrate is able to propel humans well into their 80’s and 90’s with similar values. The inflammation and metabolic disturbances linked to carbohydrate largely stem from excessive intake and a large calorie surplus. It is much more difficult to over consume calories on the ketogenic diet, but there are still potential issues only time will tell us. As a practitioner, I am most concerned with the long-term impact of a high fat diet on the digestive tract and accessory organs. We know too much sugar wears on our pancreas and causes insulin resistance. Is it possible that a diet with high levels of fat will wear in our production of pancreatic lipase and lead to pancreatitis? I am also concerned with the effects on the gallbladder, liver and our lymphatic system. Finally, while short-term observations suggest no adverse effects on lipid profile, we simply do not know the long-term impact on lipid levels or the cardiovascular system.

Overall, it becomes clear that while this diet has great promise in certain populations, there are severe barriers to sustainability, as well as large gaps in our understanding of the long-term impact on the body. Until more research is presented, the scope of this diet is fairly limited. Personally, I am most excited about the potential application in non-insulin dependent diabetics, as well as in ultra-endurance athletes during their training and competitive seasons. For the general population I still promote the idea of carbohydrate management as opposed to elimination, but there is always a need for Case Specific Nutrition!

Below are some links to the most comprehensive materials I know of. Much of the research on ketogenic dieting and performance was done by Dr. Jeff Volek & Dr. Stephen D. Phinney, and can be accessed at.

http://www.artandscienceoflowcarb.com/

Dr. Peter Attia is a fascinating man with a great understanding of the physiology and potential in ketogenic dieting. For a great explanation of how our body runs on fat, I recommend his post “Keto 101”

http://eatingacademy.com/

For any other questions or concerns, fell free to contact me at casespecificnutrition.com or Pittsburgh-dietitian.com

 

Intermittent Fasting

Is Intermittent Fasting a Diet fad or return to a more logical eating style? There are so many diet trends. Even as a nutrition expert it becomes easy to brush past them as “just another pitch”. To avoid this, I remind myself I am a counselor, and as such I need to be prepared to field a variety of questions. I need to be able to promote or breakdown any concept that comes my way. So, a few years ago, when Intermittent Fasting (IF) came across my desk in a conversation, I decided to dive into the research. Initially unsure of the concept, I dove into the forum corners of the internet to learn what IF was, then like any good medical professional, I turned to the literature for supporting rationale. To my surprise, the concept held weight. Here is the who, what and why about what IF can do for the body.

The phrase “intermittent fasting” sounds intimidating to the average person. Our society has become so fearful of any level of hunger (or too excited by feelings of complete fullness) that the word fast often becomes synonymous with starve. IF is not starving. At baseline, it is a very intuitive concept: our body does not need food all the time. If we look back over human history, we can see that food abundance has only existed in the last 100 years, and food excess for the masses is only as recent as the 1950s and 1960s. Before these periods, most people had some level of food scarcity. That meant missing a meal occasionally or frequently. Once again our minds shift to the suffering of the great depression, or an image of a homeless person looking for a chance to eat. IF is not the same as those things. Instead, IF is the practice of shrinking the time in which you eat. There are 24 hours in a day, and ideally we are not eating, or in a fed state, for a majority of those hours. Keeping food in a 12 hour span is step 1 for any IF dieter. Why?

Without going into too much detail, every time our body eats, we secrete insulin. Insulin is a storage hormone, it signals our body to store. When we eat too often or during too long of a period, insulin gets secreted, and the levels rise in the blood. This leads to two things: increased appetite and further increased insulin. This is why snacking gets so out of control. We eat something small, it digests quickly, insulin spikes, the food stores, we get hungry again, eat, insulin spikes once again before the previous meals hormone secretion is gone. Insulin accumulates and over time our body becomes used to it. Just like an antibiotic, we need a higher dose to do the same thing. Our body produces more insulin, which makes us even hungrier and signals the body to store. This cycle leads to the grazing tendencies of many cultures. Want to perform a fun test? Walk down a busy city street. If there are a bunch of kiosks and storefronts selling snacks, chances are you will see higher rates of obesity than in cities where the focus is on main meals (snacking is absent).

To summarize what we just discussed: IF at its base is controlling the hours you eat to allow insulin levels to drop back to a normal baseline. This regulates appetite, and gets your body out of the “storage mode” it knows too well. For women, eating in an 8-10 hour span is recommended for weight loss. For men, 10-12 hours is usually a small enough window to find benefit. If you are an athlete, or performing a physically demanding event, these rules should not apply. The “intermittent” part of this concept is that it should fit your schedule. I find it helps my patients to either think about it as: break your fast 12 hours from last night’s dinner, or eat dinner within 12 hours of when you eat breakfast. Either way, it forces you to think about when you are eating, which is something we all need help with from time to time.

*** Mythbust *** Breakfast: In the US, the “Breakfast” meal is the meal we eat when we wake up. Everywhere else, and more accurately, it is the first meal of the day- the meal that literally Breaks your Fast! This can be 6a, 9a, 1p, etc. Whatever you eat first is breakfast. So, if your lunch meal is your first meal, it is also your breakfast meal. This is important. The comment “Breakfast is the most important meal of the day” is only true if you are talking about it as the first meal of the day. This is because the quality and balance of food is extremely important in regulating appetite. An easy example to consider is comparing someone who rolls out of bed, grabs a granola bar and a coffee and starts their day, to a person who gets up, drinks some water, gets ready, goes to work, checks some emails, then takes a break around 9 to heat up oatmeal with some nuts and berries in it. Who will be hungrier at lunch? Who is more likely to make a better choice at lunch? Because of the breakfast and lunch meal, who is most likely to raid the vending machine for some simple and sugary? The quality of breakfast matters more than the time it occurs.

The focus on quality becomes relevant to all our meals. I always tell my clients that snacks snooze your appetite, they delay the appetite to a later time, while meals satisfy. A focus on real food at key points in the day is extremely valuable. Our society has evolved from a 3 meal per day society into a snack all day society over the past 50 years. We can thank our busy schedules and the time demand that comes with hyper productive technology and automation. Unfortunately, these advances have led to a work force that sacrifices it’s short-term energy and long term health to meet the demands. The disappearance of minimally processed, filling meals at breakfast and lunch is closely correlated to the tendency to over eat at night, complain of cravings, energy dips in the afternoon and of course, snacking. Is correlation causation? Perhaps not always, but I guarantee many of you reading are seeing consistencies.

With the focus on quality comes the focus on spread of food. Once we keep our food in a set period of time, we want to make sure there is time between meals. This allows insulin to rise, fall and dissolve. This regulates appetite and most people notice themselves needing to eat less often immediately. That is the core concept of a breakfast, lunch and dinner. Snacks are meant to bridge gaps. They are not a daily need to entitlement. They are valuable to curb appetite until quality food can be consumed. They are useful for athletes or those participating in demanding physical feats. Most often, our meals should be our priority.

Once you have selected or identified the hours to keep your food in, an ideal spread of quality food to keep your body satisfied, you are ready to see the steady benefits of eating the way our body intended. Instead of following a meal plan that forces you to eat when you are full, or even worse a meal plan that has you counting the minutes to your next meal, IF allows your body to find a natural rhythm.

For those with high fasted insulin levels (lab draws and symptoms can confirm), the next phase of the intermittent fast is to pick 1-2 days per week and extend the fasted period. For the extended fast, if you normally eat in a 12 hour span, shrink food to an 8 hour span. This extension of the fast drops insulin levels further, and allows the body to get into an unfed state. Don’t worry, this is not something that “crashes” your metabolism. You are not skipping meals. You are controlling when you eat. Your body still has adequate food coming in, it is just spaced in a more practical way for weight loss.

***Let me guess, your personal trainer tells you that you’re going to wither away or lose muscle. Something to remember: bodybuilders and individuals building muscle want high insulin levels- they are extremely active, with high levels of muscle mass, so storage means additional growth of these tissues. Further, they do not have excess fat cells signaling storage into fat, rather they have excess muscle cells asking for energy. So, the lean and fit trainer that boasts about the 6 meals per day they eat- good for them, I do that too! There are definitely people who benefit from that, but many of the overweight and obese clients seeking our advice are looking to shed weight and adjust their hormones. For these people, the “eat more to lose” will often times lead to frustration. Additionally, our bodies have evolved over a long period of time, and humans have survived thousands of years of famines, droughts, and periods of scarcity. If the first thing our body did when we missed a meal was ate our muscle, we would not have survived the trials of time. Our body does not want to consume our muscle tissue. That is a last resort. It is worth noting however that our body does closely regulate muscle. It only keeps what it needs. So for the bodybuilder with an extra 40 lbs of lean mass, if it does not get used, the body will break it down. This is where the fear of muscle wasting comes from. Once again, advice that is relevant to a specific population, yet somehow made it to the ears of the general public. For those who do not have excessive muscle, fear not, your biceps are safe.

Another common concern that goes along with the fear of muscle wasting is that not eating will ruin your metabolism. Something that most do not understand is the metabolism is just a title for the total burn of the body. Our cells and organs use energy to survive, heal, reproduce and function daily. Our heart beats, our brain thinks, our nerves conduct, our cells divide. These events require energy and produce heat (measured in calories) as a byproduct. While it is true that out metabolism varies (+/- about 40% on any day), fasting does not lead to permanent reductions in metabolic rate, especially when compared to standard caloric restriction. Eating less in general reduces metabolism, but with IF, you are not necessarily eating less. Many times, you are simply eating in a more natural, regulated, and intuitive way, which is quite beneficial. Remember, there is a difference between the person that skips meals thanks to stress all day then settles for low quality food and the intermittent faster than plans when to eat and focuses on the quality of food to regulate insulin and other hormones.

Just like every dietary concept, this is not a one size fits all. Not everyone should do this, and not everyone benefits from this concept. During consultations, my team evaluates our patients extensively before building a program. This is a tool we use for those with hormonal barriers to weight loss. The people that are maintaining or gaining weight on low calorie diets are the most common population. On the contrary,  IF is rarely a recommendation you see in the lean and fit, the athletes, the hypermetabolic, and those losing weight for the first time. Our body is a complex system, and IF is just another key that can help some unlock their puzzle of optimal health.

 

Additional Tips:

• Water, Unsweetened Tea, Black coffee are okay in the fasted state
• No artificial sweeteners during fasted state
• Fasting in the morning is often the easiest time (our breakfast sparks our appetite) – it is easier to stay fasted once fasting.
• Extended fasts are easiest on days with less physical activity and days with mental stimulation. A busy morning flys by.
• If you are exercising to perform- do not fast on those
• If you are exercising to lose fat (slow and steady cardio) you can fast
• Fasting does not need to occur daily, look at your schedule and listen to your body
• Ask to have your fasted insulin levels checked- it is not a common lab to order

 

 FILL MY PLATE, HOLD THE WEIGHT GAIN

With the Holiday Season right around the corner, most families are filling their refrigerators and bringing out the pants with the elastic band. If your priority this season is to eat yourself into a food coma and sleep through the Thanksgiving Day football game, more power to you! But what about those of us currently focused on losing weight? After months of careful planning the pounds are coming off, and the holidays present a new obstacle many fell unprepared to face. How can we be expected to over come the temptation? The secret lies within the Lifestyle Triad: balance, moderation, and variety. Here are some tips to help you and your goals survive the holiday season.

GENERAL TIPS TO PREVENT WEIGHT GAIN

• Do not expect to lose weight, instead focus on preventing gaining weight.
• Remember that bodyweight fluctuates throughout the day, so a change on the scale may not reflect fat added.
• A larger calorie surplus leads to a proportional gain in weight. Even if you eat too much, stopping will allow for damage control.
• Don’t completely restrict yourself; Allow yourself to enjoy realistic portions of traditional holiday foods.
• Save your calories for the foods you truly love.

SIMPLE WAYS TO CUT CALORIES

 

• Survey the spread before making your plate. It’s always disappointing to get to the heart of a buffet line and see your favorite dish with no room left on your plate (Why did I get the buttered roll and bread?). Solve this problem before you get in line with some strategic reserving of plate space.
• Don’t skip breakfast & lunch to save space for a big meal. This will cause overeating, and the meal will be guaranteed to surpass your needs.
• Eat a snack containing fiber and protein before leaving home to eat less.
• Limit beverage intake so you can eat your calories instead of drink them.
• When you are a guest, bring a low calorie dish to share.
• Try not to hang out near the food.
• Watch portion sizes. Eat slowly and focus on flavor.
• Select your preferred carb and fat sources, allocate plate space, and fill the rest in with steamed vegetables!
• Eat vegetables first to get the body to fill up more quickly.
• Don’t feel obligated to clean your plate if you get full sooner than expected.
• Eat until satisfied not stuffed; you can always eat again in a couple hours!
• Stop eating frequently to socialize.

QUICK WAYS TO BURN CALORIES

• Walking, running, stair climbing can be done anywhere and takes 30 minutes.
• Resistance bands fit into suitcases and can work out the entire body.
• Tabata, cross fit, yoga, and many other exercises can be done in a home with limited space in less than 30 minutes.
• Most towns have a Thanksgiving 5k walk/run (“Turkey Trot”) -Start a new tradition!
• Do an outdoor activity (weather permitting) before the big feast.

INGREDIENT SUBSTITUTIONS

• Reduce fat by replacing oil with applesauce in baking.
• Use a banana as a substitute for oil or butter.
• Reduce sugar and fat in recipes by adding protein sources.
• Greek Yogurt is a great substitute for sour cream, and can be used with spices and mixes to a make high protein, low fat, low carbohydrate dips! This greatly reduces the calories eaten subconsciously (Damage control).
• Using spray butter to flavor your mashed potatoes is a great way to reduce calories and save flavor!
• Use an egg white and 1 Tbsp. of powdered flax seed instead of a whole egg.
• Use ground oatmeal, almond flour, and coconut flour instead of white flour to reduce calories and add a unique taste to the dish.
• Almond milk can be used to replace milk in recipes. Choose unsweetened for the best calorie savings.
• Use nuts and dried fruit in baking mixes to add flavor and texture instead of candied bits and frosting.
• Black Bean brownies sound odd to many, but are very hard to distinguish from normal brownies.
• Oats can be used for breadcrumbs. This isn’t guaranteed to provide a reduction in calories, but usually has more fiber than the bread it replaces.

SEASONAL FUNCTIONAL FOODS

• Winter squash and pumpkin can be used in sweet & savory recipes.
  • Good sources of complex carbohydrates, vitamins and minerals.
  • Contains Beta-carotene, vitamin C, Riboflavin, Iron.
  • Functional Ingredients in pies, cookies, custards, soups, side dish.
  • Pumpkin Seeds can be toasted for high-fiber snack.
  • Contains phytosterols, folate, tocopherols, carotenoids, phosphorus, selenium, and zinc.
• Bright orange and yellow squash (ex. Butternut)
  • Commonly sliced, stewed, boiled, and baked.
  • Contains Carotenes, lutein, calcium, and magnesium.
  • Acorn and Hubbard squash are good sources of potassium and fiber.
• Apples
  • Crab, bramley, Jonathan best for pies, cakes, crisps, and chutneys.
  • Golden or Red Delicious best for eating.
  • Contain phytosterols, quercetin, vitamin C, beta-carotene, and lutein.
  • Source of Pectin: Soluble fiber, which slows digestion and helps, reduce cholesterol.

Remember, moderation is key. You can enjoy the food and your surroundings without eating excessive quantities. Planning ahead and keeping some of these tips in mind should help you navigate your holiday offering!

Fueling for Progress

Diet and exercise always work well together. Whether you are trying to build muscle, lose weight, or optimize performance, one without the other compromises results. When an athlete follows a structured exercise routine and fails to eat properly, optimum performance cannot exist. In competition, this is a tragedy. All the time and sweat invested in training wasted because the plate was deprioritized. Investing in your diet is crucial, and hopefully with these tips, it will be much easier to prioritize!

Sometimes it seems we forget the actual purpose of food is to provide us with the energy and nutrients we need to function. Once you starting eating to fuel your body based on what it needs, you have the opportunity to find a new level of performance. Optimizing your diet to accomplish this does not sacrifice taste, and is definitely not restricting. Instead, it encourages a variety of foods as sources of the many nutrients your body needs, in moderate portions that translate to a balanced diet on the plate.

As someone who relies on physical performance, you owe it to yourself to eat well. Find your physical goal and pair your training with nutrition to accomplish it. On your plate look for a balance of all three macronutrients and the many micronutrients using a variety of foods. If you are overwhelmed by the dietary approaches to exercise, schedule a consultation with a Sports Dietitian!

 

Macronutrient 101

Carbohydrates: Short-term physical energy. The more active you are in a day, the more you need for energy to perform and recover.

Sources: Fruits, Grains (Bread, Rice, Pasta etc.), Dairy, Starchy Vegetables (Potatoes, Turnips, Parsnips), Sweet Vegetables (Tomatoes, Peppers, Onions)

Protein: Nutrient required for optimum recovery and maintenance of body processes (Growth, development, Tissue Maintenance, Hormone Production)

Sources: Meats, Eggs, Dairy, Soy, Nuts, Seeds, Beans, and Grains

Fat: Energy source your body uses most at lower activity levels. Also needed for the body to maintain skin, hair, hormone function, and absorb the fat-soluble vitamins! Always remember fat does not make you fat. It adds up in calories quickly, but is a necessary part of the daily diet to stay healthy and promote fitness!

Sources: Nuts, Seeds, Vegetable Oils, Avocado, Eggs, Dairy, and Meat

Remember: Performing and feeling your best requires all 3 nutrients above, from a variety of sources everyday! Balance, Moderation and Variety is the key to fitness.

As a fitness enthusiast, you need all nutrients. The recent excitement over low-carb dieting is a guaranteed way to suppress performance, especially in endurance sports. While some new research suggests a high-fat diet can provide sustained energy for elite performance, the evidence is not quite there. While dietary advice, driven mainly by the media, has taken a stance against carbohydrate in recent years, the fact remains that they are the most valuable macronutrient for an athlete’s performance. Without carbohydrate, muscles fatigue faster and cannot perform at peak levels. To ensure you are performing at your best, make sure carbohydrates are in your diet. It should be different types of carbohydrates, from a variety of sources. They should be in the meals proceeding and following exercise to maximize short-term energy stores and encourage recovery after.

Protein and fat are also important, but are less affected by exercise. Your protein needs will increase slightly based on training goals, and fat generally only changes when total calories change. Even though they do not change as frequently based on duration and level of activity, they are both critical to sustain performance in the long-term. Without appropriate amounts of fat and protein your muscles will suffer, and they won’t be the only organ system to get upset. Make sure you are getting protein at each meal, with a larger portion in the evenings. Fats can be eaten anytime, but should come from a variety of sources, mostly plant-based. Keep an eye on the serving size of your fat sources, they add up quickly.

In addition to your macronutrients you have the often-overshadowed micronutrients. Without vitamins, minerals, electrolytes, and antioxidants, your body won’t be able to use any of your macronutrients for the thousands of processes that are happening every second in your body as you’re reading this. Make sure you are getting vitamins and minerals from fruits, vegetables, grains, nuts, seeds, and the animal products. If you don’t eat one or more of these categories, you are likely missing some critical nutrients, and should consider talking to a Dietitian to figure out how to compensate!

 

Example Meal Plan for Male: 2360 kcal Meal Plan (1900kcal on Off Days)

            80g Fat          160g Protein                       250g Carbohydrate

 

Meal 1:  (65g CHO, 45g Protein, 20g Fat)

1 scoop Protein Powder (24g Protein, 4g CHO, 1.5g Fat)

½ cup Oats (27g CHO, 5g Protein, 3g Fat)

8oz Milk (1g Fat, 12g CHO, 8g Protein)

2 Tbsp Peanut Butter (16g Fat, 7g CHO, 7g Protein)

1 Banana or 1 cup Berries (15g CHO)

 

OR ½ cup Egg Whites w/ ¼ cup cheese, spinach, onions, peppers

½ cup Oats with 6oz Milk (36g CHO, 14g Protein, 3g Fat)

1 cup Fruit (Berries, Peaches etc) w/ 2 Tbsp Peanut Butter

 

Meal 2: (60g CHO, 45g Protein, 20g Fat)

5oz Chicken Breast OR other Meat (35g Protein, 3g Fat) (Palm Sized)

1 cup Brown Rice/Potato/Pasta (42g CHO, 6g Protein, 3g Fat)

OR 2 slices Bread/Pita/Wrap

1-cup cooked Non-Starchy Vegetables (8g CHO)

¾ cup Avocado (16g Fat, 9g CHO, 2g Protein) OR 1.5 Tbsp Mayo

*Easy Chipotle Salad if you need to go out to lunch

OR 7” Oven Roasted Chicken on Wheat Bread with cheese, veggies, buffalo sauce and light mayo at Subway

 

Meal 3: (50g CHO, 25g Protein, 18g Fat) (75-90minutes Pre)

6oz Flavored Greek Yogurt (14g Protein, 21g CHO) ***Can have at lunch

1 English Muffin OR Bagel Thin (23g CHO, 3g Protein, 1.5g Fat)

2 Tbsp Peanut Butter (16g Fat, 8g CHO, 8g Protein)

 

Meal 4: (75g CHO, 45g Protein, 22g Fat)

5oz Chicken/Pork/Beef/Fish (35g Protein, 1-7g Fat) (Palm Size)

*On evenings with more fatty meat add less oil or other fat source

1.5 cup Sweet Potato/Pasta/Rice (63g CHO, 6g Protein) (Fist Sized)

1.5 cup Vegetables (12g CHO) (Fist Sized)

Use 1 Tbsp of Olive Oil to Prepare food (14g Fat)

 

*On Off Days, Remove Snack from the day.

 

 

Example Meal Plan for Female: 1565 kcal Meal Plan

            65g Fat                      90g Protein                         155g Carbohydrate

 

Meal 1:  (30g CHO, 20g Protein, 12g Fat)

½ scoop Protein Powder (12g Protein, 2g CHO, 1g Fat)

8oz of Almond Milk (2.5g Fat, 1g CHO, 1g Protein)

1 Tbsp Peanut Butter (8g Fat, 4g CHO, 4g Protein)

¼ cup Oats (13g CHO, 3g Protein, 2g Fat)

½ cup Berries (8g CHO)

1 bunch of Spinach

*Blend as smoothie

 

OR 2 Slices Wheat Toast, 1 Tbsp Peanut Butter & 1 Light & Fit Greek Yogurt

OR ½ cup Oatmeal w/ ½ scoop Protein, 6oz Almond Milk & 1 Tbsp PB

OR One of the Breakfast Blog Handout Ideas!

 

Meal 2: (35g CHO, 18g Protein, 15g Fat)

2oz Chicken or Turkey Breast (12g Protein, 1g Fat)

½ cup Potato/Pasta/Rice (21g CHO, 3g Protein, 1.5g Fat)

OR Wrap/Flatbread/Pita/Whole Wheat Bread

1-cup Non-Starchy Vegetables (Raw or Cooked) (15g CHO)

*Look at steam fresh bags with blend of Veg and Grain/Potato for convenience

½ cup Avocado (11g Fat, 4g CHO, 2g Protein) OR 1/3 cup Hummus OR 1 Tbsp Mayo

 

Meal 3: (20g CHO, 5g Protein, 10g Fat)(Great Pre-workout Meal)

1 Tbsp Peanut Butter OR 1/8 cup Nuts (9g Fat, 4g CHO, 4g Protein)

1 Piece of Fruit OR 1 cup Berries (15g CHO)

OR ¼ cup Dried Fruit with ¼ cup Nuts

OR Bear Naked Bar or LaraBar

 

Meal 4: (35g CHO, 25g Protein, 17g Fat)

3oz Chicken, Beef, Fish (Seared, Grilled, Broiled) (21g Protein, 1g Fat) (Palm Size)

½ cup Potato/Rice/Quinoa (21g Cho, 3g Protein)

1-cup Vegetable (carrots, peppers, broccoli, asparagus, spinach etc) (15g CHO)

Use 1 Tbsp of Olive Oil to Prepare food (14g Fat) (Less if Fatty Meat)

 

Meal 5: (35g CHO, 22g Protein, 10g Fat)

1 Light & Fit Greek Yogurt (OR Plain GY with 2 Tsp Honey)(11g CHO, 12g Protein)

¼ cup Bear Naked 10g Protein Granola (13g CHO, 10g Protein, 5g Fat)

2 tsp Dark Chocolate Chips (9g CHO, 5g Fat)

 

*On Non exercise Days skip chocolate and granola in yogurt (OR remove 20g CHO elsewhere in plan)

 

 

Recommendations provided by Andrew M. Wade, RDN, LDN. Andrew is a Registered Dietitian, and owner of Case Specific Nutrition in Pittsburgh, PA. Nutrition counseling for sports performance, weight loss, and healthy lifestyle available for individuals, families and groups.

Body Composition:

We bill insurance based on BMI. Unfortunately, the body mass index does not consider everything. The study done to create the BMI chart was attempting to prove correlation between weight and chronic disease risk. It was correlated, and the health industry took it as gold. Unfortunately, our recent research has not overcome this outdated pillar. In 2013 when obesity was diagnosed as a disease, it was finally time to address the elephant in the room. Yes, obesity increases risk of chronic disease. But obesity it not weight, it is excess fat tissue. So why do we continue to recommend weight ranges without reference to muscle mass? In our modern society we have a much larger focus on muscle growth. We eat more protein, exercise in more muscle promoting ways, play more intense recreational sports. Additionally, those suffering from obesity are carrying around hundreds of pounds. If you wore a 100lb weight vest all day, every stair case is a lunge, every time you sit up and down a squat, and walking is a form of moderate intensity cardio. If you did this for hours per day, you would build muscle. So do those suffer from obesity! So now it is time for them to lose weight. Why are we telling them to conform to a weight range from 60 years ago with limited muscle mass? It makes more sense to remove the tissue (fat) that we know causes the chronic disease. Preserving muscle becomes beneficial and practical. Enter body composition assessment.

We now know the body fat ranges that more precisely define obesity:

Body Fat Ranges:

 

Male:

8-12% extra lean

12-15% lean (Ideal)

15-18% normal (ideal for less active)

<20% goal for males over age 40

25% obesity

 

Female:

16-20% extra lean

20-24% lean (ideal)

25-30% is normal (Ideal for less active)

35% and below ideal for 50+ (shoot for 30% or lower)

38% obesity

 

These values allow us to see how much fat a person needs to lose to reduce the hormone cascade fats cells cause. This reduction in signaling means reductions in blood pressure, blood sugar, cholesterol, and as a result chronic disease progression. They also tend to excite patients, and help them feel like their goal is more personalized, logical and attainable.

Ex: 6’, 300lb man with 30% body fat

300lbs x 30% = 90lbs of fat mass, 210lbs fat free mass

So this man has 210lbs of muscle, bone, skin, organs, water etc. Why would we tell him to weigh 176lbs for the BMI chart?

I always assume large guys lose 10-15lbs of water weight. So if he has 195lbs fat free mass we want to keep (210ls-15lbs water), and we want him at 15% body fat, that is 195lbs/85% = 230lbs. That is this man’s IBW after accounting for his muscle mass. At that weight he has no excess fat, which means no adipocyte stimulated hormone flux, and no risk of chronic disease related to body composition. Are his muscles causing diabetes? No they stimulate GLUT 4 and use sugar. Are they affecting his cholesterol and blood pressure? Not likely, their function leads to HDL increase, use of fatty acids, and vasodilation…

Now we have a 6’ tall man with an encouraging and practical goal based on modern science.

 

 

Vexing Vocabulary: Exploring Energy

“I feel like I don’t have any energy. What can I eat to give me energy?” This is a quote I hear from new clients on a regular basis in my private practice. Being a Dietitian and self-cited mediator of information, what better way to answer this question then a quick Google search? In 0.28 seconds, Google finds me 24 million results that supposedly answer this seemingly popular issue. Upon further inspection of the information at my fingertips, I find an article on Business Insider: “10 Foods that will give you energy”. Sounds perfect!  Here is an abbreviated list of the cited foods:

     Almonds, Dark chocolate, Salmon, Spicy herbs, Greek Yogurt

     Popcorn, Leafy Greens, Whole Grains, Blueberries, Eggs

That is a nice list covering a variety of nutrient dense foods. Is the impact on the body that all of these foods share the fact that they give you energy? Your answer likely depends on how you define energy. For the purpose of this blog, I will group the many possible definitions of energy into 3 main groups.

Group one is what I call daily energy. This is the most traditional sense of the word, as it refers to calorie containing foods, aka what our body burns when we expend energy! It is what allows us to do things like think and move (fairly important…). The sources of energy that permit this are carbohydrates, fat, and protein. Water and sleep also fall into this group because without any one of these our body cannot function for extended periods at an optimum level. More specifically, carbohydrates are the most direct form of energy, and the preferred fuel source for our brain and muscles. A small, portioned carbohydrate based snack can do a lot for mental clarity and your short-term energy levels.

Group two is what I refer to as enhanced energy. This refers to things that give you a jittery sensation or an elevated sense of vigor through nerve stimulation. The most common example of this is caffeine. Caffeine gives us “energy” by inhibiting a regulatory neurotransmitter that essentially let’s our main source of neural stimulation run free. This is a direct up regulation of our nerves, which gives us a feeling of liveliness many wish to replicate non-stop. There is evidence this temporarily improves performance and concentration, but is generally not sustained for extended periods (hence “enhanced”).

Our third group is what I call assisted energy. The assistants are what help our body regulate the pathways of daily and enhanced energy (calories and our nervous & endocrine system). Without this group, our body would not be able to produce actual energy for daily processes. In this sense, they are an indirect source of energy. This becomes important when we reveal what this group consists of. The energy assistants are exercise, vitamins and minerals. Why does this matter? Energy drinks and energy shots, all touting ability to provide lasting energy, and boasting a B-vitamin complex fit for a week of intake are the reason this group makes energy such a vexing word. The main role of B-vitamins in “energy processes” is in the metabolism of carbohydrates, fats and protein. Our body relies on them to breakdown our true energy.  When you realize the B’s don’t provide direct energy (unless you are deficient and begin consuming it), it becomes obvious that the “more is better” mentality does not make sense. Your body needs a certain amount of each of the B-vitamins to carry out specific processes. Less than that amount, you are not running at max efficiency and will have reduced energy, but consuming excess has no enhancing impact on energy levels.

With the definition in place, let’s revisit that list from the business insider again:

Almonds: Fats, Protein, Vitamin E, Minerals

Dark chocolate: Caffeine (& other Methyxanthine), sugar, fat, phytonutrients

Salmon: fat, protein, vitamin E, iron

Spicy herbs: phytonutrients, trace vitamins/minerals

Greek Yogurt: protein, carbohydrate, minerals

Popcorn: carbohydrate

Leafy Greens: fiber, vitamins, minerals, phytonutrients

Whole Grains: carbohydrates, minerals

Blueberries: carbohydrates, vitamins, phytonutrients

Eggs: protein, fat, vitamins, minerals

Once we break out the main nutrients each food provides, a couple things become obvious. Clearly, there is not a common nutrient or ingredient that ties these foods together. Instead, the energy they provide is a result of a diet that follows the Lifestyle Triad: Balance, Moderation, and Variety.

The next time you are feeling fatigued, instead of buying a B-complex at GNC or slinging back a redbull with a triple shot of expresso, try assessing your lifestyle. Chances are one of the following is out of balance. Correct the issue and overcome the problem!

 

Are you sleeping enough? (6-8hrs)

Are you eating enough? (calories, fluids)

Are you exercising regularly? (150 minutes per week minimum)

Are you eating enough of the right foods? (vegetables, grains, proteins, fats)

Are you more stressed than normal?

 

Andrew Wade

Registered Dietitian

Pittsburgh-dietitian.com

Casespecificnutrition.com